Implementation and Outcomes of an Evidence-Based Medication Management Algorithm Project in the Treatment of Schizophrenia: Results of a 3-Year Study

2.50
Hdl Handle:
http://hdl.handle.net/10755/151278
Type:
Presentation
Title:
Implementation and Outcomes of an Evidence-Based Medication Management Algorithm Project in the Treatment of Schizophrenia: Results of a 3-Year Study
Abstract:
Implementation and Outcomes of an Evidence-Based Medication Management Algorithm Project in the Treatment of Schizophrenia: Results of a 3-Year Study
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Howard, Patricia B., PhD, RN, CNAA
P.I. Institution Name:University of Kentucky
Title:Associate Professor
Co-Authors:Peggy El-Mallakh, PhD, RN; Andrew T. Cooley, MD; Alexander L. Miller, MD and Gary R. Bond, PhD
[Research Presentation] Evidence-based practices are clinical interventions that demonstrate scientific evidence for efficacy and improved patient outcomes.áThe purpose of this presentation is to report findings from a SAMHSA-funded Medication Management Algorithm Project (MedMAP) that investigated prescriber fidelity, or degree of implementation, of a medication algorithm in 6 community mental health clinics in a south-eastern state of the US. MedMAP Fidelity Tools for prescriber interviews and chart audits were used during data collection over a 3 year period. The study sample consisted of 9 physicians and 5 advanced practice psychiatric nurses with prescriptive authority who provided mental health services to consumers diagnosed with schizophrenia. The MedMAP Fidelity Scale Outpatient Chart Review Form was used to measure prescriber fidelity to 15 critical ingredients of the medication algorithm. Quantitative data were collected in audits of 900 randomly selected patient charts at the 6 participating sites. Qualitative data were obtained from collection and analysis of 70 prescriber interviews. Results suggest that fidelity scores were high for comprehensive documentation of treatment (83-100% fidelity), use of recommended dose ranges (73-100% fidelity), simplification of medication regimen (73-93% fidelity) and patient involvement in treatment decisions (77-100% fidelity). Overall scores for patient education were lower (23-93% fidelity). Fidelity scores were lowest for documentation of illness and medication history (3-38% fidelity), linkage of medication use with treatment goals (0-7% fidelity), monitoring medication side effects (0-17% fidelity), and the use of quantitative outcome assessment tools to measure patient symptoms and functioning (0-33% fidelity). Prescribers reported that several factors influenced the degree of implementation, including billing issues, Medicaid requirements for pre-authorization of medications, time constraints when seeing patients, cost of medications, and lack of ongoing education about the algorithm.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementation and Outcomes of an Evidence-Based Medication Management Algorithm Project in the Treatment of Schizophrenia: Results of a 3-Year Studyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151278-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementation and Outcomes of an Evidence-Based Medication Management Algorithm Project in the Treatment of Schizophrenia: Results of a 3-Year Study</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Howard, Patricia B., PhD, RN, CNAA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Kentucky</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">pbhowa00@uky.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Peggy El-Mallakh, PhD, RN; Andrew T. Cooley, MD; Alexander L. Miller, MD and Gary R. Bond, PhD</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] Evidence-based practices are clinical interventions that demonstrate scientific evidence for efficacy and improved patient outcomes.&aacute;The purpose of this presentation is to report findings from a SAMHSA-funded Medication Management Algorithm Project (MedMAP) that investigated prescriber fidelity, or degree of implementation, of a medication algorithm in 6 community mental health clinics in a south-eastern state of the US. MedMAP Fidelity Tools for prescriber interviews and chart audits were used during data collection over a 3 year period. The study sample consisted of 9 physicians and 5 advanced practice psychiatric nurses with prescriptive authority who provided mental health services to consumers diagnosed with schizophrenia. The MedMAP Fidelity Scale Outpatient Chart Review Form was used to measure prescriber fidelity to 15 critical ingredients of the medication algorithm. Quantitative data were collected in audits of 900 randomly selected patient charts at the 6 participating sites. Qualitative data were obtained from collection and analysis of 70 prescriber interviews. Results suggest that fidelity scores were high for comprehensive documentation of treatment (83-100% fidelity), use of recommended dose ranges (73-100% fidelity), simplification of medication regimen (73-93% fidelity) and patient involvement in treatment decisions (77-100% fidelity). Overall scores for patient education were lower (23-93% fidelity). Fidelity scores were lowest for documentation of illness and medication history (3-38% fidelity), linkage of medication use with treatment goals (0-7% fidelity), monitoring medication side effects (0-17% fidelity), and the use of quantitative outcome assessment tools to measure patient symptoms and functioning (0-33% fidelity). Prescribers reported that several factors influenced the degree of implementation, including billing issues, Medicaid requirements for pre-authorization of medications, time constraints when seeing patients, cost of medications, and lack of ongoing education about the algorithm.</td></tr></table>en_GB
dc.date.available2011-10-26T10:57:18Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:57:18Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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